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Arch Iran Med. 2019;22(8):420-428.
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  PDF Download: 162

Original Article

Timing of Elective Cesarean Section and Growth and Psychomotor Developmental Indices in 6-Month-Old Infants

Mahboobeh Shirazi 1, Neda Hajiha 2, Zahra Khalaj Sereshki 3, Mohammad Reza Zarkesh 4, Mamak Shariat 2, Mahbod Ebrahimi 5 *

1 Maternal, Fetal and Neonatal Research Center and Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
3 Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Neonatology, Yas Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
5 IVF Unit, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Mahbod Ebrahimi, MD; Sarv Ave., North Nejatolahi St., Tehran, Iran. Tel: +989171721788, Email: Email: Maeb214@yahoo.com

Abstract

Background: In the present study, we evaluated post-natal growth and psychomotor development status of infants at 6 months of age based on their gestational age at elective cesarean sections.

Methods: This is a prospective cohort study performed in 2014-2015 in Iran. The study population consisted of 6-month-old infants with gestational ages of 38–40 weeks delivered by elective cesarean section. The subjects were divided into 3 groups: Group A (neonates with gestational age of 380/7 weeks), group B (neonates with gestational age of 390/7 weeks), and group C (neonates with gestational age of 406/7 weeks). At the infant age of 6 months, the mothers were called for follow-up visits. Growth and psychomotor status of all subjects were assessed by expert pediatricians based on the Age and Stage Questionnaires. Recorded data related to outcomes in neonatal period and 6 months later were analyzed to determine associations between groups’ variables.

Results: A total of 952 subjects were found eligible for study participation. The mean birth weight, length and head circumference were significantly higher in group C compared with the other groups (P=0.005). Regarding growth parameters, a significant association was found between gestational age at birth and all other growth indices at 6 months of age (P=0.005). The mean weight at 6 months of age was higher in group B in comparison with group A (P=0.001) and C (P=0.007). Infants born at 380/7 weeks were shorter in comparison with those born at 390/7 (P=0.002) and 406/7 weeks (P=0.005). Head circumference was significantly lower in group A than group B (P=0.02) and C (P=0.05). Regarding psychomotor indices at 6 months, a significant association was found between gestational age at birth and problem-solving skills (P=0.003). Delays in problem-solving skills were more frequent in neonates born at 380/7 weeks compared with those born at 390/7 (P=0.005) or 406/7 weeks (P=0.003). This difference was also significant between the two groups who were born at 390/7 and 406/7 weeks (P=0.01).

Conclusion: The results from this study demonstrated that postponing the time of planned elective cesareans beyond 39 weeks of gestation may improve infant’s growth and psychomotor outcomes.

Keywords: Elective cesarean, Gestational age, Growth and psychomotor development status, Infants, Timing of delivery
Cite this article as: Shirazi M, Hajiha N, Khalaj Sereshki Z, Zarkesh MR, Shariat M, Ebrahimi M. Timing of elective cesarean section and growth and psychomotor developmental indices in 6-month-old infants. Arch Iran Med. 2019;22(8):420–428.
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Submitted: 15 Jan 2018
Accepted: 26 Apr 2019
First published online: 01 Aug 2019
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